Provider Demographics
NPI:1083732234
Name:WEST, ERIC PAUL SR
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:PAUL
Last Name:WEST
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 CALIFORNIA AVE
Mailing Address - Street 2:SUITE #K-358
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1152
Mailing Address - Country:US
Mailing Address - Phone:661-319-7977
Mailing Address - Fax:661-835-7676
Practice Address - Street 1:6113 TOBIAS WAY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-3470
Practice Address - Country:US
Practice Address - Phone:661-835-7676
Practice Address - Fax:661-835-7676
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral